VD Quiz 2 Chapter 3 Flashcards by Joanna Wende

Dysphonia

the absence of current organic pathology, without obvious psychogenic or neurologic etiology

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A very common voice disorder.

Muscle Tension Dysphonia

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What is persistent MTD a result of?

excessive laryngeal and related musculoskeletal tenstion

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What is persistent MTD a result of other than excessive laryngeal and related musculoskeletal tension?

hyper functional true/or false vocal fold vibratory patterns

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What needs to be considered when categorizing MTD as primary or secondary?

Based on whether organic pathologic conditions contribute to trigger the muscle tension behavior

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Dysphonia in the absence of current organic pathology.

Primary MTD

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Compensatory response to the primary etiology of dysphonia in the absence of current organic pathology.

Secondary MTD

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Excessive, atypical or abnormal laryngeal muscle movements

Primary & Secondary MTD

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Deviant body posture and misuse of neck and shoulder muscles.

Factor contributing to MTD

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High stress levels

Factor contributing to MTD

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Excessive voice use

Factor contributing to MTD

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Persistently loud voice use

Factor contributing to MTD

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Laryngopharyngeal reflux disease

Factor contributing to MTD

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Vocal fold nodule

Benign laryngeal pathology resulting from MTD

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Vocal fold polyp

Benign laryngeal pathology resulting from MTD

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Reinke’s edema

Benign laryngeal pathology resulting from MTD

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Located in the glottal margin of each fold (anterior-middle third junction)

vocal fold nodule

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In its early stage it is soft/pliable, reddish

Vocal fold nodule

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In its aged and chronic stage it appears hard and white.

Vocal fold nodule.

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Continuous abuse of the larynx and misuse of the voice causes this pathology.

vocal fold nodule

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What is compensatory muscular tension a symptom of?

vocal fold nodule

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What is increased laryngeal effort a symptom of?

vocal fold nodules

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What is incoordination of respiration/phonation a symptom of?

vocal fold nodules

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Large vocal fold nodules may cause trouble doing what?

breathing (dyspnea)

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VF cover is stiff and more massive, and vibration is aperiodic; posterior glottal chink may be observed with hourglass closure. What is this a voice symptom of?

vocal fold nodules

What is this a voice acoustic of? Breathiness and are wastage

Vocal fold nodules

What is this a voice acoustic of? Hoarse voice quality

Vocal fold nodules

What is this a voice acoustic of? Decreased Fo and pitch range.

vocal fold nodules

What is this a voice acoustic of? Decreased habitual loudness and dynamic range.

vocal fold nodules

What is this a voice acoustic of? Increased perturbation rates jitter/shimmer.

vocal fold nodules

What is this a voice acoustic of? Vocal fatigue, frequent throat clearing.

vocal fold nodules

What is this a voice acoustic of? higher than normal air flows (aerodynamic features)

vocal fold nodules

What behaviors do you want to address by having the client reduce or eliminate?

smoking excess volume vocal abuse at public events singing style

What should the client increase if they have VF nodules?

hydration

How long will it take the nodule to go away?

as long as it took to develop

Localized, fluid filled sac on the vocal fold.

Vocal fold polyp

Pedunculated; attached by slim stalk

vocal fold polyp

sessile; blister adhere to mucosa

vocal fold polyp

hemorrhagic; blood filled

vocal fold polyp

Location: free margin of TVF

usually unilateral (90%) can be bilateral

Arise at same location as nodules.

vocal fold polyp

Arise on superficial lamina propria, but deeper than nodules

vocal fold poyp

pathology due to a single vocal event

vocal fold polyp

can resolve spontaneously

vocal fold polyp

Voice symptoms are similar to those of nodule.

vocal fold polyp

Voice symptom: incomplete vocal fold closure

vocal fold polyp

Voice symptom: decreased phonation time

vocal fold polyp

Voice symptom: decreases pitch

vocal fold polyp

Voice symptom: reduced dynamic range

vocal fold polyp

Surgery first and then voice treatment for what?

vocal fold polyps

what are the 4 stages of microflap surgery?

1. small incision 2. raise flap 3. remove contents via suction 4. lay flap down

What are the 2 goals of vocal fold polyp surgery?

1. save as much of superficial lamina propria as possible | 2. disrupt the glottal margin as little as possible

What is a goal is voice polyp therapy?

reduce secondary habits

What secondary habits should be reduced for vocal fold polyps?

overdriving hard voice onset secondary strain

What other habit should be reduced outside of secondary habits?

abusive

What should patients with vocal fold polyps practice?

vocal hygeine

Usually bilateral and asymmetric

Reinke's edema

folds appear fluid filled

reinke's edema

Extreme cases confused with polyps

reinke's edema

in stobe, folds appear stiff

reinke's edema

What is the cause of reinke's edema?

hyper-function smoking extreme allergies

This occurs more in females.

Reinke's edema

Voice acoustic: decreased fundamental frequency

reinke's edema

Voice acoustic: decrease of range and extension of low end

reinke's edema

Voice acoustic: increased perturbation; aperiodicity of voice

reinke's edema

Voice acoustic: greater than normal flow loops

reinke's edema

Reinke's edema and related conditions are often responsive to what?

voice therapy

Treatment: reduce abuse

reinke's edema

Treatment: decrease intensity

reinke's edema

Treatment: noise in talking environmant

reinke's edema

Treatment: decrease/stop "throat clearing"

reinke's edema

Treatment: Limited vocal rest, 3-4 weeks

reinke's edema

Treatment: increase hydration

reinke's edema

Treatment: re-eval in 3-4 weeks

reinke's edema

What is success from voice therapy highly dependent on?

eliminating the cause of the problem, such as smoking

increased tension or strain

misuse behavior

3 examples of increased tension or strain

hard glottal attack high laryngeal position anteroposterior laryngeal squeezing

Inappropriate pitch level

misuse behavior

3 examples of inappropriate pitch level

1. persistant glottal fry 2. lack of pitch variability 3. puberphonia

Excessive talking

misuse behavior

ventricular phonation

misuse behavior

excessive, prolonged loudness

abusive behaviors

strained and excessive use during swelling, inflammation, or other tissue chanves

abusive behaviors

excessive coughing and throat clearing

abusive behaviors

scream or noise maker

abusive behaviors